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Cardiac interventional radiology (IVR) has gained popularity since the late 1980s. An extensive search of literature published from 1996 to 2009 identified 78 reports regarding radiation-induced skin injuries (RISI) following cardiac IVR. The authors present a case report and a review of the relevant literature. A 59-year-old man underwent percutaneous transluminal coronary angioplasty (PTCA). The estimated cumulative skin dose was 11.8 Gy. The patient discovered erosions on the right upper arm 2 months after PTCA. The lesion did not resolve with conservative treatment, and evolved into an intractable skin ulcer. The authors surgically removed the lesion and reconstructed the defect using an anterolateral thigh (ALT) flap. Radiation-induced skin injuries following PTCA usually develop on the back, and rarely on the upper arm. Radiation ulceration commonly requires surgical intervention. Physicians should be aware of the possibility of RISI, and thus, take measures to minimize exposure of patients and staff to radiation. .

Intractable skin ulcers resulting from diabetes, ischemia and collagen diseases represent significant problems with few solutions. Cell-based therapy may hold promise in overcoming such disorders. In order to establish a suitable experimental model for the treatment of such ulcers using stem cells, this chapter describes detailed methods for: (1) isolation of stem cells from adipose tissue, termed adipose-derived stem cells (ASCs), (2) preparing a hybrid-type artificial dermis that consists of a type I collagen sponge and ASCs, (3) preparing intractable ulcers using Mitomycin C, and (4) evaluating the effect of wound healing histologically. ASCs seeded onto a type I collagen sponge are applied to intractable ulcers induced by topical application of Mitomycin C. Histological evaluation after 1 and 2 weeks revealed an increase in capillary density and granulation thickness of the hybrid-type artificial dermis. These findings suggest that ASCs may have a positive effect on wound healing and may be a useful tool for future cell-based therapy.

We aimed to evaluate the effectiveness of the application of an atelocollagen matrix containing autologous adipose tissue-derived stromal cells (ASCs) on wound healing in diabetic (db/db) mice. Cultured ASCs from db/db mice and from db/+ mice secreted identical amounts of growth factors, cytokines, and type I collagen. ASCs from db/db mice proliferated at the same rate as those from db/+ mice. When DiI-labeled ASCs were applied to full-thickness round skin wounds on the backs of diabetic db/db mice, histological observation at 2 weeks showed that red fluorescent-labeled tissues were formed in the epidermis, dermis, and capillaries. Twelve db/db mice were treated with either matrix alone or matrix containing ASCs and then sacrificed at 1 or 2 weeks. A histological examination demonstrated significantly advanced granulation tissue formation, capillary formation, and epithelialization in those wounds treated with atelocollagen matrix containing ASCs, compared with wounds treated with matrix alone.

We prepared fragmin/protamine microparticles (F/P MPs) as cell carriers to enhance cell viability. Use of material consisting of a low-molecular-weight heparin (fragmin) mixed with protamine resulted in water-insoluble microparticles (about 0.5-1 microm in diameter). In this study, we investigated the capability of F/P MPs to enhance the viabilities of human microvascular endothelial cells (HMVECs), human dermal fibroblasts (fibroblasts), and adipose tissue-derived stromal cells (ATSCs) in suspension culture. F/P MPs were bound to the surfaces of these cells, and the interaction of these cells with F/P MPs induced cells/F/P MPs-aggregate formations in vitro, and maintained viabilities of those cells for at least 3 days. The ATSCs/F/P MPs-aggregates adhered to and grew on suspension culture plates in a fashion similar to those on type I collagen-coated plates. The cultured ATSCs secreted significant amounts of angiogenic heparin-binding growth factors such as FGF-2. When the ATSCs/F/P MPs-aggregates were subcutaneously injected into the back of nude mice, significant neovascularization and fibrous tissue formation were induced near the site of injection from day 3 to week 2. The ATSCs/F/P MPs-aggregates were thus useful and convenient biomaterials for cell-therapy of angiogenesis., ((c) 2009 Wiley Periodicals, Inc.)

We produced a chitosan/fucoidan micro complex-hydrogel as a carrier for controlled release of heparin binding growth factors such as fibroblast growth factor (FGF)-2. Material consisting of a soluble chitosan (CH-LA) mixed with fucoidan yielded a water-insoluble and injectable hydrogel with filamentous particles. In this study, we examined the ability of the chitosan/fucoidan complex-hydrogel to immobilize FGF-2 and to protect its activity, as well as the controlled release of FGF-2 molecules. The chitosan/fucoidan complex-hydrogel has high affinity for FGF-2 (K(d) = 5.4 x 10(-) (9)M). The interaction of FGF-2 with chitosan/fucoidan complex-hydrogel substantially prolonged the biological half-life time of FGF-2. It also protected FGF-2 from inactivation, for example by heat and proteolysis, and enhance FGF-2 activity. When FGF-2-containing complex-hydrogel was subcutaneously injected into the back of mice, significant neovascularization and fibrous tissue formation were induced near the site of injection at 1 week, and the complex-hydrogel was biodegraded and disappeared by 4 weeks. These findings indicate that controlled release of biologically active FGF-2 molecules is caused by both slow diffusion and biodegradation of the complex-hydrogel, and that subsequent induction of vascularization occurs. FGF-2-containing chitosan/fucoidan micro complex-hydrogel is thus useful and convenient for treatment of ischemic disease., (Copyright 2007 Wiley Periodicals, Inc.)